Lilli Amba Coombes - Tragic Story

A tragic story of the loss of one families daughter during a VBAC due to uterine rupture.

Born 18/04/05 at 3.20am
Weighing 8lb 8oz and 55cm long

You were a complete surprise to us at first but how wonderful for Jack (your big brother now 3 ½) to have a play mate. At 6 ½ weeks we had our first scan and your due date was April 18th 2005. We didn’t want to know what sex you were as it’s the best surprise waiting and guessing. After having an emergency caesarean with Jack I decided that I’d really like to try again for a natural birth (VBAC vaginal birth after caesarean). As the pregnancy went on and things were going great our doctor and gynaecologist agreed we could try for VBAC as my previous scar was good and if there were any problems they would just have to do another caesarean.

It was a good pregnancy, I felt healthier than I had with Jack the only thing that really got to me was the summer heat. The 12 and 18 week scans were perfect; as the weeks went by we all got excited about your arrival. Jack practised changing nappies on his doll and teddies; he was going to be such a little helper.

On April 17th while having tea in bed the first mild contractions started, so after having breakfast and doing a few things we phoned Nanny and Grandad to say things might be happening today. By the time they arrived my contractions had stopped so after having some lunch we sent them home, only to phone again around 4.30pm to say it’s on for sure this time. We said goodbye and gave Jack the biggest cuddles and said he would have a brother or sister by tomorrow. While waiting to be transferred from Gympie to Nambour, I recall saying to Robin, why don’t we just have a caesarean as it was much more painful than with Jack. I arrived at Nambour around 9.00pm and Robin was there shortly after, we had the same midwife as we’d had with Jack which was nice.

I was given pethidine after some time as the gas just wasn’t helping anymore; this of course made me drowsy so my recollection of events is very blurred. I remember being told on numerous occasions that I was doing well and at least I was dilating this time. My waters were broken and a trace was put on Lillis head, this was the best way to keep a check on her heart beat. Later the midwife told me that if I didn’t stop pushing they would have to give me an epidural as I was only 7cm and it could bruise the babies head. I jumped at the opportunity as I just wasn’t coping with the pain, neither was Robin as I had been crushing his hand for hours now. Once this was done around midnight I think, I relaxed and rested while they kept checking everything.

I guess I must have even slept as I don’t remember much until the midwife said she would top up the epidural again. She had only just finished doing this when the constant beeping of Lillis heart beat slowed drastically, people seemed to come from nowhere. One of the midwives checked the trace to Lilli’s head, it seemed ok but he replaced it just to be sure it hadn’t come loose. Still no change the beeping was getting slower and slower, I never said a word as it seemed like chaos. After trying another machine, there was still no change. I was shaved and the midwife put a line in my arm. This was not easy as in the last six weeks of pregnancy I blow up like a balloon with fluid. By this time we were surrounded by Doctors, the first line was removed and a doctor inserted another (I have curly veins).

It was while he was doing this that the most incredible pain started, I felt as though someone was ripping my ribs apart and as I looked down, my belly had changed shape. It was excruciating and I was begging them to knock me out while they wheeled me down to theatre. I begged again and again, please knock me out and just before they did one of the Doctor’s asked who was that at the theatre doors, it was Robin. Then the Doctor said to get him away from there, that’s all I remember and you know to this day it never ever entered my head that they wouldn’t get Lilli out alive.

Very, very groggy and really not at all with it, I remember Robin was leaning over me with a Doctor next to him and those words I shall never forget, “darling she didn’t make it , Lilli didn’t make it”. It was one of those extremely rare cases were the uterus had ruptured, mainly on the previous scar. I had lost a lot of blood and Lilli’s little head had come through the tear, it was just too much for her. As I was not awake for most of the first day Robin and the midwife washed, dressed and took Lilli’s hand and foot prints which we have now framed and will treasure forever. Robin had the horrendous task of phoning my parents and telling them what had happened. They came with Jack and my brother to share some very sad but special cuddles with Lilli. That night after kissing Lilli on the head one last time we said goodbye.

Robin had to go home and make all those phone calls to family and friends waiting for what should have been good news. We were told on many occasions that I was lucky to be alive but this made little difference, we just wanted our dear Lilli back.

It’s been almost a year now and we just keep plugging at living our lives, Jack has been the best medicine he really has kept us going. Only the other day he asked me if he could undo Lilli’s belt and take off her wings then she could get in the pool and play with him. Jack involves Lilli in his games all the time, it’s wonderful to see.

The incidence of babies dying in labour after their mothers had a previous caesarean is very rare. The following excerpt is from www.vbac.com

With access to a rapid caesarean, fetal death from a uterine rupture is an extremely rare event. Three large studies that determined the number of babies who died as a direct result from a uterine rupture when women laboured for a VBAC found the following:

Number of women who laboured for a VBAC

Number of babies who died from uterine rupture

Reference

17,613

5

Rageth, et al 2000

10,000

3

Rosen, et al 1991

5,022

0

Flamm, et al 1994

The Vermont/New Hampshire VBAC Project findings show the overall risk of infant death from a VBAC attempt is 6 per 10,000 compared to 3 per 10,000 planned caesarean births.